학술논문
VALsartan In Acute myocardial iNfarcTion (VALIANT) trial: baseline characteristics in context
Document Type
Journal Article
Author
Velazquez, Eric J.; Pfeffer, Marc A.; McMurray, John V.; Maggioni, Aldo P.; Rouleau, Jean-Lucien; Van de Werf, Frans; Kober, Lars; White, Harvey D.; Swedberg, Karl; Leimberger, Jeffrey D.; Gallo, Paul; Sellers, Mary Ann; Edwards, Susan; Henis, Marc; Califf, Robert M.; VALIANT Investigators, for the; VALIANT Investigators (CORPORATE AUTHOR)
Source
Subject
*MYOCARDIAL infarction
*CORONARY disease
*ANGIOTENSINS
*PLACEBOS
*HEART diseases
*CAPTOPRIL
*PEPTIDES
*HETEROCYCLIC compounds
*OXIDOREDUCTASES
*HEART ventricle diseases
*CLINICAL trials
*COMPARATIVE studies
*LEFT heart ventricle
*HEART failure
*RESEARCH methodology
*MEDICAL cooperation
*RESEARCH
*VALINE
*EVALUATION research
*BLIND experiment
*ANGIOTENSIN receptors
*THERAPEUTICS
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Language
ISSN
1388-9842
Abstract
Background: the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial compared outcomes with: (1) angiotensin-converting enzyme inhibition (ACEI) with the reference agent captopril; (2) angiotensin-receptor blockade (ARB) with valsartan; or (3) both in patients with heart failure (HF) and/or left ventricular systolic dysfunction (LVSD) after myocardial infarction (MI). Aims: a goal of this active-control trial was to simulate conditions that would lead current practitioners to use ACEIs. Thus, we compared characteristics of VALIANT patients with those of patients in placebo-controlled trials that established ACEIs as standard treatment. Methods and Results: we collected demographic, clinical, medication and imaging information from 14 703 patients in 24 countries. This high-risk population was a median 65.8 years old, and 31.1% were female. Most (51.8%) showed imaging evidence of LVSD at enrollment. Most (72%) had Killip class≥II HF. Patients received evidence-based therapies at rates similar to those of contemporary MI trials and at an improved rate compared with prior placebo-controlled ACEI trials. Conclusion: VALIANT represents the largest globally representative cohort enrolled with HF and/or LVSD after MI. Patients were similar to those in placebo-controlled ACEI trials while reflecting improvements in evidence-based care. With enrollment complete, VALIANT is poised to define the optimal strategy for renin–angiotensin system blockade after MI to improve cardiovascular outcomes. [Copyright &y& Elsevier]